Lower Extremity Review
Significant progress has been made in quantifying gait impairment in patients with multiple sclerosis, but clinician-friendly assessment techniques that are sensitive to mild levels of impairment are needed to facilitate early intervention and in turn improve patient outcomes.
By Douglas A. Wajda and Jacob J. Sosnoff, PhD
I can’t recall exactly when the bunion on my left foot started causing discomfort, but it was probably when I was about 40. I waited some time to get a referral to a podiatrist, and when I finally saw one, life with two kids and a full-time job stalled my pursuit of treatment for another three and half years.
By Karen Bakar
Military populations experience high rates of disability related to post-traumatic osteoarthritis (PTOA), which does not always originate from combat injury. But military researchers are also uniquely positioned to explore therapeutic options to minimize the effect of PTOA.
By Jessica C. Rivera, MD, Joseph C. Wenke, PhD, James R. Ficke, MD, and Anthony E. Johnson, MD
Variables related to iliotibial band strain appear to be important risk factors for development of iliotibial band syndrome (ITBS) in runners, a finding that is beginning to change the way researchers assess the effectiveness of gait retraining interventions to treat or prevent ITBS.
By Stacey Meardon, PT, PhD, ATC, CSCS, and Ross H. Miller, PhD
Kicking is a whole-body movement that is responsive to a wide range of constraints related to the task, the environment, and the athlete. Preliminary research also suggests that balance control in the support leg plays a key role in athletes’ kicking performance.
By David I. Anderson, PhD, and Ben Sidaway, PT, PhD
Learned disuse of the affected limb can lead to weight-bearing asymmetries in patients with stroke-related hemiparesis. Compelled body-weight shift therapy, using shoe inserts to force loading of the affected limb, can help patients achieve a more symmetrical gait.
By Alexander S. Aruin, PhD
Although the technique is still in its infancy, early research suggests gait retraining can be used to address medial collapse, primarily in runners with patellofemoral pain (PFP) syndrome, and to reduce impact loading in runners with PFP or tibial stress fracture.
By Ashlin Miller, BS, and Richard W. Willy, PhD, PT, OCS
Practitioners and researchers are redefining rocking and rolling as key components of gait, and designing ankle foot orthoses and other orthotic and prosthetic devices to specifically address impairments in the way certain patients rock and roll.
By Cary Groner
Documenting how shock propagates through the leg and is attenuated by the soft tissues appears to be a critical step toward advancing practitioners’ and researchers’ understanding of lower extremity injury mechanisms related to running and landing activities.
By Timothy A. Burkhart, PhD, EIT, Alison Schinkel-Ivy, MHK, and David M. Andrews, PhD
Given the limitations of pharmacotherapy options for treating painful diabetic peripheral neuropathy, practitioners are also considering the merits of cognitive therapy, orthotic management, and combination therapies to relieve patients’ pain.
By Larry Hand
Ankle foot orthoses can help compensate for muscle weakness and accommodate related structural deformities in patients with Charcot-Marie-Tooth disease, but practitioners are constantly looking for ways to improve suboptimal compliance rates.
By Cary Groner
Researchers have identified gait alterations in patients with diabetic peripheral neuropathy but also in diabetic patients with normal sensation, raising questions about the extent to which factors other than neuropathy might also be affecting gait.
By Cary Groner
Balance testing is already recommended for concussion assessment in athletes, but research suggests the connections between concussion and neuromuscular variables are even more complex, and the opportunities for intervention more numerous.
By Brent Harper, PT, DPT, DSc, OCS, FAAOMPT
Artificial turf technology has advanced significantly, and some research suggests newer surfaces are as safe as grass, if not safer. But in other reports, including a high-profile NFL study, turf has been associated with higher rates of lower extremity injury.
By P.K. Daniel
US orthopedic surgeons perform more than 25,000 microfractures annually, making the procedure the most common marrow-stimulating technique used for repair of the cartilage defects that often affect active individuals.1 Although microfracture is a single-stage, low-cost intervention that requires only surgical time and common surgical tools, it requires…
By Emily Delzell
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